关节内注射透明质酸对前交叉韧带横断术后垂直地面反作用力及骨关节炎进展的影响

Effect of intraarticular hyaluronan injection on vertical ground reaction force and progression of osteoarthritis after anterior cruciate ligament transection.

作者信息

Smith Gerald, Myers Stephen L, Brandt Kenneth D, Mickler Elizabeth A, Albrecht Marjorie E

机构信息

Rheumatology Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.

出版信息

J Rheumatol. 2005 Feb;32(2):325-34.

PMID:15693095

Abstract

OBJECTIVE

To determine if intraarticular (IA) injection of hyaluronan (HA) into the canine knee after anterior cruciate ligament transection (ACLT) alters the progression of osteoarthritis (OA) and the perception of pain in this model.

METHODS

OA was induced in 30 adult dogs of mixed breed by ACLT. The dogs were divided into 3 groups and given 5 weekly IA injections into the unstable knee during Weeks 1-5 and 13-17. The prophylactic treatment group received HA in the first series and saline during the second series. The therapeutic group received saline in the first series and HA in the second series. The control group received saline during both injection series. The progression of joint damage of OA was evaluated by arthroscopy 12 weeks after ACLT and by gross examination 32 weeks after ACLT. Histologic and biochemical changes of OA were evaluated. Loading of the unstable limb during gait was determined by force-plate analysis before surgery, after each series of injections, and the week before euthanasia.

RESULTS

Arthroscopic examination 12 weeks after ACLT revealed OA changes in the cruciate-deficient knees. Chondropathy scores ranged from 0 to 8 (possible range 0-65). The mean chondropathy score was 2.5 +/- 1.3 (mean +/- SD) for the controls, 2.5 +/- 2.5 for the therapeutic group, and 2.1 +/- 1.3 for the prophylactic group. At the termination of the experiment 32 weeks after ACLT, the gross chondropathy scores were 14.0 +/- 5.2 for controls, 17.6 +/- 6.8 for the therapeutic group, and 13.3 +/- 5.0 for the prophylactic group. There were no significant differences among the means of the gross scores, the histologic scores, or biochemical composition of articular cartilage. The peak vertical ground reaction force (VGRF) generated by the unstable limb was reduced by ~60% after ACLT, and slowly increased to ~75% of the baseline value over the 32 weeks after ACLT. HA injection had no effect on the VGRF or on the pathologic changes of OA.

CONCLUSION

Intraarticular HA injection did not alter the progression of OA in the cruciate-deficient canine knee or alter the loading of the unstable limb.

摘要

目的

确定在前交叉韧带横断（ACLT）后向犬膝关节内注射透明质酸（HA）是否会改变骨关节炎（OA）的进展以及该模型中的疼痛感知。

方法

通过ACLT诱导30只成年杂种犬患骨关节炎。将犬分为3组，在第1 - 5周和第13 - 17周期间，每周向不稳定膝关节内注射5次。预防性治疗组在第一阶段接受HA，第二阶段接受生理盐水。治疗组在第一阶段接受生理盐水，第二阶段接受HA。对照组在两个注射阶段均接受生理盐水。在ACLT后12周通过关节镜检查以及在ACLT后32周通过大体检查评估OA关节损伤的进展。评估OA的组织学和生化变化。通过力板分析在手术前、每个注射阶段后以及安乐死的前一周确定不稳定肢体在步态中的负荷。

结果

ACLT后12周的关节镜检查显示交叉韧带损伤的膝关节出现OA变化。软骨病评分范围为0至8（可能范围为0 - 65）。对照组的平均软骨病评分为2.5±1.3（平均值±标准差），治疗组为2.5±2.5，预防性治疗组为2.1±1.3。在ACLT后32周实验结束时，大体软骨病评分对照组为14.0±5.2，治疗组为17.6±6.8，预防性治疗组为13.3±5.0。在大体评分、组织学评分或关节软骨的生化组成的平均值之间没有显著差异。ACLT后，不稳定肢体产生的垂直地面反作用力峰值（VGRF）降低了约60%，并在ACLT后的32周内缓慢增加至基线值的约75%。HA注射对VGRF或OA的病理变化没有影响。